The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. In August of 2019 we published a brief commentary in Bipolar Disorders concerning the role of telemental health via videoconferencing (TMH‐V) in the treatment of bipolar disorder.1 We concluded that this technology

The aim was to describe the pre‐diagnostic and post‐diagnostic psychopharmacological treatment of bipolar disorder over the past two decades.

The long‐term use of lithium salts has long been associated with tubular damage and chronic kidney disease development. Nevertheless, there is some interest in the potential role of these drugs in inflammatory pathways regulation including those pathways in the setting of acute kidney injury (AKI). This therapeutic potential is based on lithium‐induced inhibitory phosphorylation of glycogen synthase

The aim of this study was to advance understanding of stage of illness in bipolar disorder (BD), by interrogating the literature for evidence of an influence of stage of illness on functional (ie non‐symptom) outcomes following psychosocial intervention.

Neurovascular abnormalities are relevant to the pathophysiology of bipolar disorder (BD), which can be assessed using cerebral blood flow (CBF) imaging. CBF alterations have been identified in BD, but studies to date have been small and inconclusive. We aimed to determine cortical gray matter CBF (GM‐CBF) differences between BD and healthy controls (HC) and to identify relationships between CBF and

Recent evidence has associated mood disorders with blood‐brain barrier (BBB)/ neurovascular unit (NVU) dysfunction, and reduction in blood vessels coverage by the water channel aquaporin‐4 (AQP4) immunoreactive astrocytes. Lithium is an established treatment for mood disorders, yet, its mechanism of action is partially understood. We investigated the effects of lithium on BBB integrity and NVU‐related

Systematic reviews suggest comorbid borderline personality disorder is present in approximately 20% of individuals who have bipolar disorder, but current diagnostic systems demonstrate a move towards dimensional rather than categorical approaches to classifying personality pathology. We aimed to examine the presence and severity of borderline personality traits in bipolar I and bipolar II disorder

Emotion regulation difficulties precipitate and exacerbate acute mood symptoms in individuals with bipolar disorder (BD), and contribute to suicidal behavior. However, few studies have examined regional brain responses in explicit emotion regulation during acute BD mood states, or hopelessness, a major suicide risk factor. We assessed brain responses during explicit emotion regulation, and their relationship

Cognitive remediation therapy (CRT) may benefit people with bipolar disorder type I and II for whom cognitive impairment is a major contributor to disability. Extensive research has demonstrated CRT to improve cognition and psychosocial functioning in people with different diagnoses, but randomised trials of evidenced therapy programmes are lacking for bipolar disorders. The Cognitive Remediation in

Lithium remains an important treatment for mood disorders but is associated with kidney disease. Nephrogenic diabetes insipidus (NDI) is associated with up to 3‐fold risk of incident chronic kidney disease among lithium users. There are limited randomized controlled trials (RCT) for treatments of lithium‐induced NDI, and existing therapies can be poorly tolerated. Therefore, novel treatments are needed

There is substantial evidence of increased prevalence of migraines, and negative psychiatric correlates of migraines, in adults with bipolar disorder (BD). Given the paucity of data on this topic in youth, we investigated the prevalence and correlates of migraine in a large sample of adolescents with BD.

This review aim was to examine whether psychotherapy is more or less effective in patients with SUD, compared to those without; whether there is a differential effect of a particular psychotherapy in patients with SUD.

Thanks to Kovvuru et al (2020) for granting us insight into the perspective of nephrology´s view on lithium regarding its potential nephrotoxicity. Renal side‐effects of long‐term lithium exposure are well known, and we concur with the proposed patient‐centered approach when determining if a patient with observed impairment of renal function should discontinue or continue lithium treatment, and in

Individuals with bipolar disorder are at increased risk of dying by suicide compared to healthy controls and those with unipolar depression. Previous studies show that depressive symptoms and mixed episodes of mania and depression are related to suicide. However, most of these studies adopt a variable‐centered approach to understanding how specific symptoms relate to suicidal ideation, without addressing

To determine the effectiveness of intravenous (IV) ketamine on anxiety, irritability, agitation, and suicidality, in adults with treatment‐resistant major depressive disorder (MDD) or bipolar disorder (BD).

Interest in biological clock pathways in bipolar disorders (BD) continues to grow, but there has yet to be an audit of circadian measurement tools for use in BD research and practice.

Key message On top of public health and economic costs, the pandemic adds strain, disrupting daily routines and service delivery. Bipolar disorder can increase vulnerability, complicate treatment, and heighten interpersonal stigma. Yet there are successes when people proactively improve social connections, prioritize self‐care, and we learn to use mobile and telehealth effectively.

Current options for treating emergent episodes of hypomania and mania in bipolar disorder are limited. Our objective was to compare the effectiveness and safety of add‐on melatonin in hypomania or mania over 3 weeks as a well‐tolerated therapy.

1. Even in cases of acoustic neuroma without psychiatric symptoms before surgical intervention, secondary mania could develop after surgery.

The aim of this study was to develop a consensus guideline by certified experts of the Japanese Society of Clinical Neuropsychopharmacology on the psychopharmacological treatment for bipolar disorders I and II (BP‐I and BP‐II), in order to fill the gap in the literature and provide more concrete guidance for challenging and controversial real‐world situations.

Recommendations on lithium dosing around delivery vary, with several guidelines suggesting that lithium should be discontinued prior to delivery. We aimed to evaluate the validity of these recommendations by investigating 1) maternal lithium blood level changes following delivery, and 2) the association between neonatal lithium blood levels at delivery and neonatal outcomes.

Depression is a common mental illness and a leading cause of disability worldwide. Despite various treatment modalities including pharmacotherapy and psychotherapy, a sizeable portion of patients fail to recover from their depressive episodes, and are diagnosed with treatment‐resistant depression (TRD). Neurosurgical methods involving lesioning or stimulating specific brain structures are a possible

Although clinical practice guidelines (CPG) identify first, second‐ and third‐line mood stabilizer (MS) treatments, they rarely define clinical response to prophylaxis or the core issues to be considered. This project aimed to develop a template for describing how clinical response may be classified and a framework to assist decision‐making and monitoring of response in day‐to‐day practice.

I read the editorial from Malhi and Bell entitled “Detecting classic bipolar disorder: A classic mistake?” with interest. I agree and appreciate that you brought many important claims to our attention. However, in the second section, “An alternative explanation: You cannot see what is not there, especially if you do not want to”, when you assert that the symptoms do not need to develop as an episode

The novel coronavirus disease (COVID‐19) pandemic represents a global health crisis which can directly or indirectly affect the mental health of millions of people around the world. There are certain aspects of this pandemic, and of the measures necessary for its control, which are of particular concern for patients with bipolar disorders, particularly as regards the risk of relapse. First, the course

The diagnostic validity and stability of major psychiatric diagnoses is an area of perennial debate and controversy. We read with great interest the prospective study by Baryshnikov et al., in which the authors investigated the occurrence of diagnostic ‘conversion’ from unipolar depression to schizophrenia, schizoaffective disorder or bipolar disorder, based on data from a 15‐year follow‐up of a nationwide

The recent article of Khan et al.1 opens a new field of research in bipolar disorders and other psychiatric disorders, which can give clues for a better understanding of their pathophysiology. These authors provide an analysis of two large national datasets, highlighting the issue of air pollution as a risk factor for major psychiatric disorders. The authors show the influence of different environmental

Psychotic illnesses often reflect cultural influences. For example, a religious person’s psychotic illness may manifest as delusions about his religion’s founder; another person may have delusions about the president of her country, or its intelligence services. As a culture changes, these shifts are evident in the presentation of psychiatric illnesses. A major shift in the last decade has been the

What is the most accurate way to capture and organize the tremendous variability in symptoms that occur within and between mood states and over the course of time in bipolar disordersThis question regularly re‐emerges underpinned by an equally fundamental question, which is the best treatment for a given patient. Indeed, the high clinical heterogeneity within a syndrome (e.g. depression), does not

Mr.AB is a61‐year old divorced male who was referred to our clinic 15 years ago with a history of depression and recurrent panic attacks. He experienced first‐onset of depression as a child, and had several episodes of depression and hypomania before he sought professional help. Family history was positive for depression and anxiety in his siblings, and his brother had died by suicide. As per the Diagnostic

A 53‐year‐old man without history of mental disorders has a history of ESRD‐induced uremia and has received continuous ambulatory peritoneal dialysis (CAPD) since September 2012. Secondary hyperparathyroidism was diagnosed three months after dialysis. Phosphorus intake was restricted and he received calcitriol but was discontinued in January 2016 due to aggravated hyperphosphatemia. Parathyroid hormone

Valproic acid (VPA) is a broad‐spectrum antiepileptic drug. It has been widely used in bipolar disorder treatment for many years. Although treatment is generally well tolerated, serious complications such as hemorrhagic pancreatitis, bone marrow suppression, hepatotoxicity and encephalopathy can occur. Because of bilateral opacity consistent with pulmonary edema, hypoxemia, increased venous admixture

We are grateful to our colleagues (Duan et al. and Allot & Van Rheenen) for their commentaries on our recent meta‐analysis that showed that longitudinal cognitive performance tends to be stable both in recent‐onset and late‐life bipolar disorder (BD)1. Although the two comments differ in their content, a main theme emerges from them: (i) given there are methodological limitations to the studies included

Dengue is a tropical arboviral infection associated with inducing mania in a few cases. Flaviviridae (including Dengue virus)with itsepigenetic influences throughhistone deacetylase (HDAC) may lead to symptom manifestations. Valproate and quetiapine have HDAC inhibitory property and may have pathophysiologically relevant effects in curtailing these symptoms.

The review by Post and colleagues1 is important. The authors, with undoubted expertise in this field, describe measures addressing clinical issues in bipolar disorders (BD). They make a number of recommendations, covering the breadth of treatments, from illness stage (first episode mania, treatment resistance) to option(therapeutic approach, a broad range of pharmacotherapies, in addition to psychosocial

This study aimed to investigate the features of later stage bipolar disorder (BD) and specifically, factors underlying later stage BD and potential subgroups within this stage, to understand more about the later stage group and contribute to the measurement of stage.

OBJECTIVES Diagnosis and management of bipolar disorder (BD) are limited by the absence of available biomarkers. Allostatic load (AL) represents the strain that stress, including the effects of acute phases and inter-episode chronic mood instability, exerts on interconnected biological systems. This study aimed to operationalize an AL index and explore whether it could be relevant to better characterize

OBJECTIVE To examine temporal patterns and predictors for diagnostic conversion from unipolar depression (UD) to bipolar disorder (BD), schizophrenia, and schizoaffective disorder (SAD). METHODS A prospective nationwide register-based cohort (n = 43 495) of all first psychiatric hospitalizations due to UD during 1996-2011 was followed up to 15 years. We used cumulative incidence function (CIF) analyses

OBJECTIVES Childhood maltreatment has been associated to an increased risk of developing bipolar disorder (BD). A role of the hypothalamus-pituitary-adrenal (HPA) axis in mediating trauma-related risk for adult psychopathology has been suggested but scarcely investigated in BD. Therefore, we explored the impact of childhood maltreatment on clinical features of BD and on the activity of the HPA axis

The diagnostic and therapeutic controversies over mixed mood states have many causes. The general problem of validity of mental disorders, the unsteady character of psychiatric symptoms, the changing diagnostic criteria and the dearth of randomized studies, especiallydesigned for the subpopulation of bipolar patients with mixed features are several reasons whichimpedethe diagnostic and treatment decisions

Transcranial direct current stimulation (tDCS) recently appeared as a novel treatment that could be a potential therapeutic option for patients with bipolar depression. tDCS is an experimental treatment and should not be considered as a treatment that can replace medications or electroconvulsive therapy in bipolar depression tDCS could be a potential effective alternative in specific neuropsychiatric

Delirious Mania (DM) is a severe and under-recognized neuropsychiatric syndrome characterized by a rapid onset of delirium, mania and psychosis. Despite being a well-described clinical entity, it is frequently unrecognized and misdiagnosed as acute episodes of organic delirium, which is dangerous because it can progress rapidly and be lethal.

The association of bipolar disorder with early and excessive cardiovascular disease was identified over a century ago. Nonetheless, the vascular‐bipolar link remains underrecognized, particularly with regard to how this link can contribute to our understanding of pathogenesis and treatment.

We recently published a debate article on the topic of cognitive interventions for mood disorders (1), which has received interest from experts in the area, including many of our respected colleagues (2, 3). We appreciate, as Burdick et al. (2) point out, that novel and important research is being conducted worldwide to address the issue of persisting cognitive impairment in mood disorders. It is therefore

Linke and collaborators published in Bipolar Disorders (December 2019) the results of a whole-brain Diffusion Tensor Imaging (DTI) study that measured fractional anisotropy (FA) (as a marker of white matter structure abnormalities) in youths with BD, non-BD first-degree relatives of individuals with BD (i.e. "at risk" individuals) and healthy controls (HC) (1). The authors reported a significant decrease

"A nosological nuisance, but a clinical reality", that is how psychiatrists Andreas Marneros and Hagop Akiskal once described schizoaffective disorder (SAD), aptly expressing a widely held view in the field and arguing for the necessity of the diagnosis. On the other hand, critics have emphasized weaknesses in the conception of schizoaffective disorder. Gin S. Malhi, to name only one of the most outspoken

Mental disorders are ranked among the most substantial causes of disability worldwide. Moreover, they are increasingly being recognized as complex diagnostic entities with largely unknown etiological backgrounds. Apart from genetic risk factors, several environmental exposures, including pregnancy and perinatal risk factors, psychosocial stressors, urbanicity, poverty and substance use, have been associated

OBJECTIVE Bipolar disorder (BD) has been associated with abnormal reward functioning including pleasure-seeking and impulsivity. Here we sought to clarify whether these changes can be attributed to abnormalities in the neural processing of reward valuation or error prediction. Moreover, we tested whether abnormalities in these processes are associated with familial vulnerability to BD. METHODS We obtained

Over the past few decades, lithium carbonate has been used as an effective therapeutic agent for the treatment of bipolar affective disorders. Lithium is an extremely potent mood stabilizer andprovides protection against both manic and depressive episodes. Lithium also plays a substantial role in reducing suicidal deaths among bipolar patients.

OBJECTIVE To reanalyze Aristotle's classic lecture, "On melancholy," with current clinical interpretations. METHOD The full lecture is described and interpreted in a new translation. RESULTS Aristotle's lecture has been understood to reflect a claim about a link between genius and madness, or more specifically depression and genius. In fact, his concept of melancholia included what today would be called

OBJECTIVES Systematically review the prevalence of functional impairment (FI) in euthymic patients with bipolar disorder (BD), as assessed only with the Functioning Assessment Short Test (FAST), explore the prevalence of this impairment among all the domains, identify the most compromised of them and the clinical variables associated with low functioning in this population. METHODS Meta-analyses were

OBJECTIVES Recent studies have suggested that evening blue light exposure is associated with sleep and circadian rhythm abnormalities. This study examined the effect of blue-blocking (BB) glasses on sleep and circadian rhythm in patients with bipolar disorder (BD). METHODS We used a randomized, placebo-controlled, double-blinded design. Outpatients with BD and also with insomnia were randomly assigned

Bipolar disorder (BD) is a psychiatric condition causing shifts in mood, energy and activity levels severely altering the quality of life of the patients even in the euthymic phase. Although widely accepted, the neurobiological bases of the disorder in the euthymic phase remain elusive. This study aims at characterizing resting state functional activity of the BD euthymic phase in order to better understand

Sleep problems are common in bipolar disorders (BDs). To objectively characterize these problems in BDs, further methodological development is needed to capture subjective insomnia.